Create Your PsychScan Pro Account

Contact Name*
Contact Email*

Practice Name*

example: Jane Smith, LCSW
example: Springfield Counseling


Your Website
This is the webpage clients will return to after completing a PsychScan assessment

Your Profession*
Do you hold a current, valid license in your mental health profession?*

Contact information to include on Client Report

This information will appear on the Client Report so prospective clients know how to reach you

Jane Smith, LCSW
1234 Main St.
Springfield, IL 12345